Systems and methods for aspirating from a body lumen

ABSTRACT

An aspiration device can be used to aspirate an obstruction from a blood vessel. The aspiration device is configured to allow controlled one-handed aspiration yet maintain a syringe plunger feel of vacuum. The aspiration device also allows one-handed injection to empty the device when needed. Furthermore, mechanisms enable one-handed locking of a plunger position of the device to maintain vacuum when the user releases the device.

REFERENCE TO PRIORITY DOCUMENT

This application is a Continuation of U.S. patent application Ser. No.14/221,917 filed Mar. 21, 2014 entitled “Systems and Methods forAspirating From A Body Lumen” issuing on Jul. 4, 2017 as U.S. Pat. No.9,693,789 and claims priority to U.S. Provisional Patent ApplicationSer. No. 61/806,707 filed Mar. 29, 2013. Priority of the aforementionedfiling dates is hereby claimed, and the disclosures of the patentapplications are hereby incorporated by reference in their entirety.

BACKGROUND

Aspiration has been used as a method to remove thrombotic blockages fromblood vessels. For example, a single lumen catheter is sometimes used toaspirate a clot from a cerebral vessel in an acute ischemic strokepatient. Such a procedure generally entails placing a distal tip of acatheter at the proximal face of the clot and applying vacuum to theclot via a proximal port of the catheter. The clot may be soft enough tobe aspirated into the catheter, or in cases of harder clots aspirationon the catheter attaches the clot to the distal tip of the catheter andthe attached clot removed together with the catheter. In some cases, theclot is broken up by mechanical means during aspiration, to aid inaspiration of the clot through the catheter.

The aspiration source may be a suction pump or simply a syringe, each ofwhich has pros and cons. An advantage of a syringe is that a syringe cangenerate near full vacuum by the user pulling back forcefully on thesyringe plunger to generate a strong force. This force is somewhatindependent of the size of the syringe, in that even a small syringe cangenerate near full vacuum. A larger syringe size simply allows a greateramount of fluid and/or clot to be aspirated during one “pull back”.

The syringe also allows the user to “feel” if the distal end of thecatheter is blocked by the tactile feedback of a counter force on theplunger of the syringe. The syringe also allows the user to easily varythe force and/or rate of suction. However, there are also somedisadvantages of a syringe. A syringe is designed for controlledone-handed injection into the vessel, which is not optimally designedfor one-handed pull back or aspiration from the vessel. To maintain afull vacuum requires constant manual hold on the syringe barrel andplunger, which can be cumbersome. If the user wishes to let go of thesyringe momentarily, the vacuum may be lost. A locking syringe may beused to counter this by permitting the user to lock the syringe in avacuum state. But such locking syringes require two hands to lock, andusually only lock in discrete positions. Moreover, locking the syringein full pull-back would remove the “feel” of the syringe plunger. Inaddition, once a syringe is filled, it needs to be removed, emptied, andreattached to the catheter if further aspiration is desired. These extrasteps require a pause in the procedure, a loss of vacuum when thesyringe is detached unless a stopcock is used, and two hands to removethe syringe.

In contrast, the suction pump is advantageous in that it is “hands free”and has unlimited length of time for suction without the need to pause,as compared to a syringe. However, there are limitations to the suctionpump. First, there is limited aspiration force as compared to a syringe,due to the dead air space in the pump. Second, the user does not havethe “feel” of suction and therefore may not realize if and when thedistal tip of the catheter is clogged. In cases where the catheter doesnot aspirate the clot but acts as a suction attachment whereby the clotcan be pulled back, knowing when the catheter “loses” vacuum can becritical. Some users will gently move the catheter forward to re-engagethe clot with the suction at the tip of the catheter when they feel thisloss. This feature is not so important when the pump is used withsystems that break up a clot, as in this case all the clot is aspiratedthrough the lumen of the catheter. However, there is clinical benefit tobeing able to remove the clot in one piece, or in as large a section aspossible due to the fact that there is less potential for pieces of clotto break off and flow distally into the brain.

A disadvantage of all current aspiration devices is the standardconnection to the catheter. Standard catheters have a female Luerconnector on the proximal end of the catheter. Any device connecting tothe female Luer connector has a male Luer connector. This type ofconnection creates a flow restriction and a step inside the Luerconnection, which may cause a clot or a portion of a clot to catch onthe step, especially in cases where a large volume clot is beingaspirated in one piece. Not only does this interfere with aspiration,but there is risk that the clot caught in the connector would be flushedback into the brain when the user flushes contrast or other solutionthrough the catheter.

SUMMARY

Disclosed is an aspiration device that can be used to aspirate anobstruction from a blood vessel. The disclosed aspiration device isconfigured to allow controlled one-handed aspiration yet maintain asyringe plunger “feel” of vacuum. The aspiration device also allowsone-handed injection to empty the device when needed. Also disclosed aremechanisms that enable one-handed locking of a plunger position of thedevice to maintain vacuum when the user releases the device. Alsodisclosed are connectors that eliminate a flow restriction or step whena device is attached to a catheter. This permits an optimization ofaspiration of clot from the catheter and all connections. Also disclosedare valve configurations that facilitate emptying the aspiration devicein cases where the aspiration device is filled but further aspiration isdesired. Embodiments that combine these features are also disclosed.

In one aspect, there is disclosed a device for aspirating fluid from abody lumen, comprising: a chamber configured to contain fluid, thechamber having an opening through which fluid can be injected out of thechamber and through which fluid can be aspirated into the chamber; aplunger having a plunger seal movably positioned inside the chamber;first and second finger elements coupled to the chamber and the plunger,wherein movement of the first and second finger elements toward oneanother causes relative movement between the plunger seal and thechamber so as to aspirate fluid into the chamber; and a lockingmechanism movable between a first state and a second state, wherein thelocking mechanism locks a position of the plunger seal relative tochamber when the locking mechanism is in the first state, and thelocking mechanism permits relative movement of the plunger seal relativeto chamber when the locking mechanism is in the second state.

In another aspect, there is disclosed an adapter for connecting a femaleluer connector to an aspiration device, the adapter comprising: astructure having a first end with an opening configured to receive thefemale Luer connector and a second end with an opening configured toreceive an end of the aspiration device; the structure having aninternal contour sized and shaped to provide a smooth transition betweenthe end of the aspiration device and the end of the female Luerconnector such that the adapter forms an internal lumen connectionbetween the aspiration device and the female Luer connector that lacksany ledges.

In another aspect, there is disclosed a stopcock valve adapted toconnect an aspiration device to a catheter, the valve comprising: afirst port configured to couple to an aspiration device; a second portconfigured to couple to a catheter; a third port configured to couple toa receptacle; and an actuator that can be actuated to control fluid flowbetween the first port and one of the second and third ports, wherein,when the actuator is in a default state, fluid flow is open between thefirst port and only the second port, and when the actuator is actuated,fluid flow is open between the first port and only the third port; and aspring mechanism that biases the actuator toward the default state.

In another aspect, there is disclosed shut off valve that controls flowof fluid between a catheter and aspiration device, the shut off valvecomprising: a structure having a first portion that attaches to acatheter and a second portion that attaches to an aspiration device; aseal inside the structure, the seal having an internal lumen thatprovides a fluid passageway between the catheter and the aspirationdevice, wherein the seal is made of a resilient material that can becompressed so as to close the internal lumen and inhibit fluid flowbetween the catheter and aspiration device; and an actuator that can beactuated to compress the seal.

In another aspect, there is disclosed a device for aspirating fluid froma body lumen, comprising: a chamber configured to contain fluid, thechamber having an opening through which fluid can be injected out of thechamber and through which fluid can be aspirated into the chamber; and avacuum indicator system coupled to the chamber, the vacuum indicatorsystem having a display that provides an indication as to a level ofvacuum inside the chamber.

Other features and advantages should be apparent from the followingdescription of various embodiments, which illustrate, by way of example,the principles of the disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an example of a syringe device configured for one handedaspiration.

FIG. 2 shows side and cross-sectional views of the syringe.

FIGS. 3 and 4 shows the syringe in use.

FIG. 5 shows embodiment of a syringe handle in an assembled state.

FIG. 6 shows the syringe handle in an exploded state.

FIG. 7 shows a standard syringe attached to the syringe handle.

FIGS. 8A and 8B show a finger toggle of the device in two positions.

FIGS. 9 and 10 show an embodiment of a syringe handle.

FIG. 11 shows a standard syringe attached to the syringe handle.

FIGS. 12 and 13 each show side and cross-sectional views of the syringehandle.

FIG. 14 shows another embodiment of a syringe handle.

FIGS. 15A and 15B show the syringe handle in use.

FIG. 16 shows a cross-sectional view of a conventional male Luerconnector on the distal tip of a syringe coupled to a female Luerconnector on the proximal end of a catheter.

FIG. 17 shows a cross sectioned perspective view of a connector adaptoron the distal tip of an aspiration device coupled to a female Luerconnector on the proximal end of a catheter.

FIG. 18 shows an adapter system in cross-section.

FIG. 19 shows another embodiment of a connector adaptor.

FIG. 20 shows a spring-loaded, push button stopcock.

FIG. 21 shows the stopcock configured for direct flow between anattached catheter and a syringe to allow for aspiration.

FIG. 22 shows the stopcock configured to allow expulsion from a syringeto an attached receptacle.

FIGS. 23 and 24 show an embodiment (in side and side cross-sectionalviews) of a valve built into a catheter proximal hub. FIG. 23 shows thehub with a valve in a closed state and FIG. 24 shows it in an openstate.

FIGS. 25 and 26 show another embodiment in cross section of a valvebuilt into a catheter proximal hub. FIG. 25 shows a device with a valvein a closed state. FIG. 26 shows the device with a valve in an openstate.

FIGS. 27A-27C show a catheter hub that includes a shut-off valveconfigured to be connected to an aspiration device

FIG. 28 shows the aspiration device connected using an unrestrictedconnector design via a push button valve to catheter.

FIGS. 29A and 29B show a cross section of an aspiration device connectedusing an unrestricted connector design via a push button valve tocatheter, with the push button valve in two different states.

DETAILED DESCRIPTION

Disclosed is an aspiration device that can be used to aspirate anobstruction from a blood vessel. The disclosed aspiration device isconfigured to allow controlled one-handed aspiration yet maintain asyringe plunger “feel” of vacuum. The aspiration device also allowsone-handed injection to empty the device when needed. Also disclosed aremechanisms that enable one-handed locking of a plunger position of thedevice to maintain vacuum when the user releases the device. Alsodisclosed are connectors that eliminate a flow restriction or step whena device is attached to a catheter. This permits an optimization ofaspiration of a clot or occlusion from the catheter and all connections.Also disclosed are valve configurations that facilitate emptying theaspiration device in cases where the aspiration device is filled butfurther aspiration is desired. Embodiments that combine these featuresare also disclosed.

Syringe-Type Aspiration Devices

There exist current syringe-type devices that are configured tofacilitate one-handed aspiration by a user squeezing portions of thedevice towards one another, rather than separating the syringe plungerand barrel as with a traditional syringe. However these types of deviceslose aspiration force when the grip on the device is relaxed orreleased. Disclosed is a one-handed aspiration device having a latchingfeature, such as a latch, detent, or other locking mechanism, thatenables locking the plunger in place, thus giving the user the abilityto maintain vacuum force even when the user's grip is relaxed orreleased from the device, i.e. a vacuum lock.

FIG. 1 shows an example of a syringe device 100 configured forone-handed aspiration. The syringe device 100 has a distal end 110through which a fluid is injected or aspirated, and a proximal end 115.The syringe 100 includes a main syringe barrel 120 that defines achamber that can contain a fluid. A syringe plunger 125 is sized andshaped to slide within the barrel 120 so as to push fluid out of thebarrel or pull fluid into the barrel in a well-known manner. An outersyringe barrel 130 is attached to the syringe plunger 125 such as viaadhesive, snap fit, screws, etc. The syringe plunger 125 and outersyringe barrel 130 collectively form a body that is slideably coupled tothe main syringe barrel 120 such that they can slide relative to themain syringe barrel 120 with a portion of the plunger 125 slidingthrough the chamber in a proximal or distal direction.

FIG. 2 shows side and cross-sectional views of the syringe 100. Thesyringe 100 includes a syringe plunger seal 320 attached to the end ofthe syringe plunger 125 to seal the fluid in the main barrel. Thesyringe 100 also includes one or more tabs 305 that are attached to adistal region of the outer syringe barrel 130. One or more tabs 310 areattached to a proximal region of the main syringe barrel 120 at alocation proximal of the tabs 305. To aspirate fluid into the chamber, auser positions his or her fingers on a distal side of the tabs 305 suchas with the index and middle fingers. The user also positions the thumbon a proximal side of the main syringe barrel tab 310, as shown in FIG.3. The index/middle fingers and thumb are then squeezed together to movethe tabs 305 and 310 toward one another, which causes the plunger 125 tomove in a proximal direction relative to the inside of the main barrelchamber. That is, the movement of the outer syringe barrel 305proximally will likewise move the syringe plunger 125 proximally(relative to the inside of the chamber) to create an aspiration force inthe barrel chamber. In an embodiment, there is a vacuum lock consistingof a latching mechanism that can fix the outer syringe barrel 130 to themain syringe barrel 120 such that when the latch is actuated, aspirationforce is maintained even if force on the finger tabs 305 and 310 arerelaxed or released. A latching mechanism may comprise a feature on theouter syringe barrel that when toggled inward engages with a feature onthe main syringe barrel to lock the two components together.

To inject or expel fluid from the barrel chamber, the user places theindex and middle fingers on a distal side of the main syringe barrelfinger tabs 310 and the thumb on a proximal or proximal-most side theplunger 125 (or on a corresponding tab attached to the plunger 125), asshown in FIG. 4. The index/middle fingers and thumb are then squeezedtogether as described above. This causes the plunger 125 to move in adistal direction relative to the inside of the main barrel chamber andexpel any fluid distally out of the chamber.

One advantage of the above-described configuration over some othersyringe handle configurations is that the sizes of the syringe 100 neednot be much bigger than the size of a standard syringe of comparablevolume. Another advantage of the syringe 100 is that the user's hand isset closer to or essentially over the body of the syringe, which allowsgood control/stabilization of the syringe as compared to some otheraspiration devices.

Another example of a one-handed manual aspiration device is a pistolgrip style design; examples are disclosed in U.S. Pat. No. 4,594,073,U.S. Pat. No. 5,115,816, U.S. Pat. No. 5,469,860, and U.S. Pat. No.5,830,152, all of which are incorporated herein by reference. In anembodiment, a pistol-grip style syringe aspiration device includes alatch mechanism to lock the plunger with respect to the main syringebarrel to create a vacuum lock. FIG. 5 shows embodiment of a syringehandle 502 in an assembled state and FIG. 6 shows the syringe handle 502in an exploded state. The syringe handle 502 has a main handle bodyformed of a right main handle body 505 and a left main handle body 510that collectively form a syringe barrel holder 507 that can receive astandard syringe 705 (as shown in FIG. 7). A slide piece 508 isslideably coupled to the syringe barrel holder 507 when the right mainhandle body 505 and left main handle body 510 are joined together. Withreference still to FIGS. 5 and 6, a finger grip 515 is coupled to theslide piece 508 and a palm grip 512 is attached to the syringe barrelholder 507. A finger toggle 520 is moveably attached to the syringebarrel holder 507 and configured to be moved upward or downward relativeto a set of teeth or ratchets 517 on the slide piece 508, such that thefinger toggle 520 engages or disengages the teeth to lock the slidepiece with respect to the syringe barrel holder 507.

With reference to FIG. 7, a standard syringe 705 can be attached to thesyringe handle 502 by pressing the syringe 705 into the barrel of thesyringe handle 502, with a flange 810 of the syringe 705 sliding into aslot of the main handle body 510, and a proximal tab 815 of a plunger ofthe syringe 705 sliding into a proximal slot of the slide piece 508. Inthis manner, the barrel of the syringe is fixed to the syringe barrelholder 507 and the syringe plunger is fixed to the slide piece 508. Inanother embodiment, the syringe 705 may be integrated into the syringehandle 502 as a monolithic structure.

To pull vacuum/aspirate fluid into the syringe 705, the toggle 520 isset to the downward (disengaged) position, and the user holds thesyringe handle 502 in a manner similar to a pistol with the index andmiddle fingers on the finger grip 515 and palm around the palm grip 512.The user then squeezes the finger grip 515 towards the palm grip 512 toaspirate. The finger toggle 520 can be engaged with the ratchets 517, bypushing the finger toggle 520 upward, at any time in order to maintainand lock vacuum on the syringe 705 by preventing motion of the syringeplunger with respect to the barrel.

FIGS. 8A and 8B show the finger toggle 520 in two positions: an unlockedposition (FIG. 8A) where the finger toggle 520 does not engage theratchets 517, and a locked position (FIG. 8B) where the finger toggle520 engages the ratchets 517 (thereby limiting movement). The toggle maybe configured with a snap feature such that the up and down positionsare two stable positions of the toggle. For example, there may be amovable projection on one side and two detents on the othercorresponding to the two positions. To inject fluid out of the syringechamber, the user moves his or her hand to the main body handle, withthe thumb placed on the back (proximal) side of the syringe plunger andpushes the thumb forward (distal) to move the plunger of the syringe ina distal direction through the chamber of the syringe.

The vacuum lock concept may be applied to other aspiration syringehandle designs, for example those disclosed in U.S. Pat. No. 3,819,091,U.S. Pat. No. 4,711,250, and U.S. Pat. No. 4,850,979. An embodiment 1005is shown in FIG. 9. FIG. 10 shows the syringe handle 1005 in an explodedstate. As best shown in FIG. 10, the syringe handle 1005 is made up ofat least four components (although the quantity of components may vary)including a main handle 1010 with a proximal palm grip 1012, a leftfinger grip 1020 a, a right finger grip 1020 b, and a finger toggle1025. The components attach to one another to collectively form theassembled syringe handle 1005. The left and right finger grips 1020 aand 1020 b are assembled to form the slideable finger grip 1015. Whenassembled, the slideable finger grip 1015 captures the finger toggle1025 and is slideably coupled to the main handle 1010.

When assembled, a standard syringe 705 can be attached to the syringehandle 1005 by pressing the barrel portion of the standard syringe intoa distal seat 1030 of the main handle 1010 with a flange of the syringebody sliding into a slot 1035 of the main handle 1010. The proximal tabof the standard syringe plunger slides into a slot 1040 of the fingergrip 1015. FIG. 11 shows the standard syringe 705 attached to thesyringe handle 1005.

The finger toggle 1025 is configured to fix the position of the fingergrip 1015 with respect to the main handle 1010 as shown in FIGS. 12 and13. In the on position shown in FIG. 12, (which may be noted by adesignation such as “O” on the finger grip), a set of internal teeth1305 of the finger toggle are disengaged from corresponding teeth 1310of the main body. The finger grip is thus free to move thereby allowingthe user to retract (pull vacuum) and advance (inject) the plunger onthe standard syringe by sliding the finger grip proximally or distally.In the off position shown in FIG. 13 (which may be noted by adesignation such as “X” on the finger grip), the internal teeth 1305 ofthe finger toggle engage the teeth 1310. This allows the user to lockthe syringe plunger in place, as is necessary to maintain and lock thevacuum.

To aspirate into the device 1005 or to create an aspiration force, theuser places the index and middle fingers through the finger grip 1015and secures the palm grip 1012 in his palm. The user then verifies thatthe finger toggle 1025 is in the on or “O” position. Using these twofingers, the user then pulls the finger grip towards the palm grip 1012of the main handle 1010. If desired, the user may then lock the syringeplunger in place (so as to maintain vacuum) by switching the fingertoggle 1025 to the “X” position using a finger such as the forefinger.The opposite motion on the finger toggle 1025 using a finger such as themiddle finger will disengage the lock. As above, the toggle may beconfigured to have two stable positions.

To inject fluid from the device, the user then moves the index andmiddle fingers to the distal portion of the syringe main handle 1010,with the thumb placed in the finger grip hole or on the back (proximal)side of the finger grip 1015, and squeezes the finger grip 1015 and palmgrip 1012 of the main handle 1010 together.

In another embodiment of the syringe handle 1005 shown in FIG. 14, thefinger toggle 1025 is positioned outside of the finger grip 1015. Thefinger toggle 1025 is positioned such that the actuation of the lockingmechanism of the finger toggle 1025 can be ergonomically performed usingthe ring finger. The finger toggle 1025 is pulled back to disengage theteeth on the main handle (as shown in FIG. 15A) and pushed forward toengage the teeth on the main handle lock the syringe plunger in place(as shown in FIG. 15b ).

During use, it is often valuable for the user to note the level ofvacuum in the aspiration device. For example, a loss of vacuum forceindicates either that the blood vessel occlusion is being suctioned orhas been suctioned into the catheter, or that the catheter tip has lostengagement with the occlusion. In addition, it may be important to knowif the vacuum is too high. In some cases a vacuum that is too high maycause damage to the catheter and/or to the vessel wall, for examplecausing the catheter to collapse. In an embodiment of the aspirationdevice, the device includes an indicator 127 (FIG. 1) which shows thelevel of vacuum in the main chamber of the aspiration device. Thisindicator may provide or otherwise indicate a pressure value, forexample in mmHg. Alternately, the indicator may show or otherwiserepresent a pressure level and include markings to show when the levelis above or below a target level. In this way, the user can visualize ifthe level of vacuum is being maintained or going down or is changing. Inan embodiment, the vacuum indicator is a simple piston on a spring thatis fluidly connected to the vacuum chamber, wherein the piston positionvaries depending on the amount of vacuum. Alternately, the vacuumindicator is a flexible bellow that has an inherent spring constant orwhich is connected to an external spring, and which shortens withincreased level of vacuum. Markings on the housing may identify thelength of the flexible bellows and relate this to the level of vacuum.

In another embodiment, the aspiration device has a feature thatmaintains a constant level of vacuum. For example the piston generatingthe vacuum is coupled to a spring such that the pull-back force isconstant. In a variation of this embodiment, the user can switch betweenmanually controlling the vacuum force and switching to automated vacuum,for example with a switch that can engage or disengage the spring thatgenerates the vacuum. This embodiment may also be used with or withoutthe vacuum indicator described above. In this version, the pull backmechanism may be coupled to the vacuum indicator to allow for a constantvacuum. For example, the vacuum indicator is an electronic vacuumsensor, which imparts a signal to a solenoid actuated piston thatgenerates the aspiration force.

Connectors

Connections to catheters have been standardized to a locking Luer taperdesign, with a male Luer taper connecting to a female Luer receptacle.The tapered connection provides a fluid-tight seal. Usually the maleLuer connector has external threads and the female Luer connector hasexternal features which can engage the threads when the connection ismade, enabling the connection to be able to withstand pressure withoutthe two sides of the connector coming apart. Typically catheter proximalhubs have a female Luer design. Syringes, stopcocks, Rotating HemostasisValves (RHVs), or other devices designed to connect to catheters have amale Luer design. FIG. 16 shows a cross-sectional view of a conventionalmale Luer connector on the distal tip of a syringe coupled to a femaleLuer connector on the proximal end of a catheter. When coupled, a distalend of the male Luer taper creates a ledge 1705 at the interface betweenthe male and female connectors. During aspiration of clot through thecatheter, the clot to may get caught or hung up on the ledge 1705. Theledge 1705 also reduces the cross sectional area of the lumen for theclot to flow through.

There is now described an unrestricted connector adaptor that replacesthe male Luer which typically attaches to a female Luer connector on acatheter. FIG. 17 shows a cross sectioned perspective view of aconnector adaptor 1805 on the distal tip of an aspiration device 1822,coupled to a female Luer connector 1810 on the proximal end of acatheter 1815. The adaptor 1805 provides a connection to the female Luerconnector which eliminates the aforementioned ledge 1705 (FIG. 16). Theadaptor 1805 does not contain a taper that fits into the femaleconnector 1810, but instead seals the connection with a gasket 1820 onthe top surface (i.e., proximal surface) of the female Luer connector1810. The adaptor 1805 can spin about a longitudinal axis of thecatheter 1815 with respect to the main body of the aspiration device1822 and contains internal threads 1817. To attach the adaptor 1805 tothe catheter, the two sides of the connection are pressed together andthe connector 1805 is rotated to secure the internal threads to theexternal threads of the female Luer 1810 on the catheter such that thegasket 1820 is compressed to provide a fluid tight seal.

FIG. 18 shows the system in cross-section, with a clearer view of theunrestricted interface between the female Luer hub of the catheter 1815and the syringe 1822 with the adaptor 1805 providing a connectionbetween the female Luer connector 1810 and the syringe 1822. The adapter1805 has a first, distal end 1801 with an opening that is configured toreceive therein the female Luer connector 1810. The gasket 1820 ispositioned inside the opening such that the gasket 1820 abuts and sealsagainst a proximal-most end of the female Luer connector 1810 when thefemale Luer connector 1810 is mounted inside the opening. The adapterhas a proximal end 1802 with an opening that receives therein the distalmost end of the syringe 1822 (or other device) through which fluid isaspirated into or injected out of the syringe. An internal contour orstructure, such as a protrusion 1807 inside the adapter 1805, links theopening that receives the syringe 1822 to the opening that receives thefemale Luer connector 1810. The protrusion is sized and shaped toprovide a smooth transition between the distal tip 1809 of the syringe1822 and the proximal tip of the female Luer connector 1810. The gasket1820 also assists in providing the smooth transition. In this manner,the adapter 1805 provides an internal lumen connection between thesyringe 1822 and the female Luer connector 1810 with the internal lumenconnection providing a smooth transition that lacks any sudden steps orledges. In this embodiment, the connector adaptor 1805 can rotate freelywith respect to the aspiration device 1822, such that the threads of thefemale Luer can be engaged without rotating the entire device. Thegasket 1820 provides a fluid seal between the adaptor 1805 and theaspiration device 1822 such that there is no internal, stepped ledge inthe lumen that connects the syringe 1822 to the catheter 1815.

FIG. 19 shows another embodiment of a connector adaptor 2005. Thisadaptor 2005 includes a clasp structure 2006 that is configured to“snap” on to a portion, such as a flange 2008, of the female connector2010. A leading edge of the flange 2008 and the clasp structure 2006form bevels such that pushing the two components together allows theclasp features to automatically open and then snap over the flange 2008.Squeezing on the back end of the clasp structure 2006 lift the front endof the clasp structure away from the flange 2008 and allows uncouplingof the connector.

Valve

In the situations where the clinician has filled the syringe to itsmaximum capacity, there is a need to expel the contents of theaspiration device, for example a syringe, in order to continue theaspiration thrombectomy. The clinician typically removes the syringefrom the catheter in order to expel the contents of the syringe. Thiscreates a loss of vacuum, as well as a risk of introducing air into thecatheter as a result of the syringe being removed. If there was a strongvacuum force in the catheter due to clot being trapped in the tip of thecatheter, for example, then there is a strong likelihood that removal ofthe syringe will draw air into the catheter. Alternatively, theclinician may attach a three-way stopcock between the catheter and thesyringe or aspiration device, wherein a third port of the stopcock leadsto a receptacle to store the aspirant. However, standard three-waystopcocks can at times be confusing as to which ports are open and whichport is closed. In addition, standard stopcocks require two hands toopen, and two hands to close. Further, the connections to standardstopcocks are Luer connections with their associated restriction andledge, creating a potential for thrombus or other emboli to be trappedin the valve.

There is now disclosed a spring-loaded, push button stopcock 2205 asshown in FIG. 20. The stopcock 2205 requires only one hand to open. Auser can simply release the stopcock 2205 to close it. The stopcock 2205includes three ports 2210, 2215, and 2220 and an actuator such as aspring-loaded button 2225.

In a default state wherein the button 2225 is not compressed, there is adirect flow between an attached catheter and a syringe to allow foraspiration, as shown in FIG. 21. When the button 2225 is actuated (suchas by being compressed), the fluid path changes to allow expulsion fromthe syringe to an attached receptacle, as shown in FIG. 22. As shown inthe embodiment in FIGS. 21 and 22, the valve connections may beconfigured to be unrestricted.

All the aforementioned valve designs may incorporate the adaptor asdescribed above to minimize the possibility of clot being trapped in thevalve during aspiration or emptying of the aspiration device.

Alternately, the catheter proximal hub may be configured with a shut offvalve such that when the aspiration device is removed, the hubautomatically closes so that there is no loss of vacuum or possibleintroduction of air. FIGS. 23 and 24 show one embodiment (in side andside cross-sectional views) of such a valve built into a catheterproximal hub 2405. FIG. 23 shows the hub 2405 with a valve in a closedstate and FIG. 24 shows it in an open state. The catheter proximal hub2405 includes a valve seat 2410, a valve cap 2420 and a valve seal 2430which is normally closed. The valve seal 2430 may be, for example anelastomeric and/or resilient seal with an inner lumen such as a shortlength of tube. The valve cap 2420 contains an inner tubular structure2422 and a proximal female Luer connector 2425. The valve seat 2410contains external threads and the valve cap contain internal threadssuch that when the cap is turned, the internal tube is pushed forward tocompress the seal 2430 such the inner lumen of the seal is occluded, asin FIG. 23. When the cap is turned in an unscrewing direction, the tubemoves back, decompressing the seal 2430 thereby allowing the inner lumento open, as in FIG. 24. The proximal female Luer connector allows thecatheter to be prepped with a standard syringe when the valve is in theopen state.

In another embodiment, as shown in FIGS. 25 and 26, the valve seat 2610and valve cap 2620 are slideably connected to one another. FIG. 25 showsthe device with a valve in a closed state and FIG. 26 shows it in anopen state. The valve seal 2630 may be, for example, a septum valve witha slit or slits. The valve cap 2620 contains an inner tubular structure2622 and a proximal female Luer connector 2625. An internal compressionspring 2615 biases the valve seat and valve cap to keeps the twocomponents normally apart, as shown in FIG. 25. When the cap is pushedforward, the internal tube 2622 is pushed forward through the valve seal2630 to open the valve, as shown in FIG. 26. A latch between the valveseat and the valve cap may keep the valve in the opened configuration.However, before the user disconnects the syringe or other aspirationdevice, the user releases the latch and the compression spring 2615pulls the internal tube 2622 away from the valve 2630 and allows thevalve to close, as in FIG. 25.

There may be embodiments of aspiration devices and catheters connectionsthat combine several of the features disclosed herein. For example, inFIGS. 27A, 27B, and 27C, a catheter hub 2805 includes a shut-off valve2815 configured to be connected to an aspiration device 2810 via anunrestricted connector. The connector may contain a latch structure 2820that locks the aspiration device 2810 to a flange structure 2825 of thehub 2805. When the aspiration device 2810 is pushed forward onto thecatheter hub 2805, an unrestricted connection is formed between theaspiration device 2810 and the catheter hub 2805 and simultaneously thevalve 2815 is opened to create a smooth and unrestricted lumen from thebody of the catheter into the aspiration device. When the aspirationdevice 2810 is removed, a spring in the shut off valve 2815 preventsloss of vacuum in the catheter.

In another embodiment, as shown in FIG. 28, the aspiration device 2900is connected using an unrestricted connector design via a push buttonvalve 2905 to the catheter 2915. This allows unrestricted aspirationthrough the catheter when the valve is in the aspiration state, as inFIG. 29A, and allows unrestricted purging of the aspiration device 2900when the valve 2905 is in a purge configuration, as in FIG. 29B. Thevalve 2905 may be monolithic with the aspiration device such that thecomponents and connections are minimized. As shown, the aspirationdevice is configured to be optimized for one-handed aspiration.

As will be apparent to those of skill in the art upon reading thisdisclosure, each of the individual embodiments described and illustratedherein has discrete components and features which may be readilyseparated from or combined with the features of any of the other severalembodiments without departing from the scope of the subject matterdescribed herein. Any recited method can be carried out in the order ofevents recited or in any other order which is logically possible.

Although embodiments of various methods and devices are described hereinin detail with reference to certain versions, it should be appreciatedthat other versions, embodiments, methods of use, and combinationsthereof are also possible. Therefore the spirit and scope of theappended claims should not be limited to the description of theembodiments contained herein.

1-21. (canceled)
 22. A device for aspirating fluid from a body lumen,comprising: an internal syringe barrel member defining a chamberconfigured to contain fluid, the chamber having an opening through whichfluid can pass; a plunger movably positioned at least partially withinthe chamber, the plunger including a plunger seal; an external syringebarrel connected to the plunger, wherein the internal syringe barrel isslidably positioned inside the external syringe barrel, wherein theplunger and the external syringe barrel collectively form a body thatcan slide relative to the internal syringe barrel; first and secondfinger elements extending outward from a proximal end of the internalsyringe barrel; third and fourth finger elements extending outward froma distal end of the external syringe barrel; wherein movement of thefirst and second finger elements toward the third and fourth fingerelements causes relative movement between the plunger seal and thechamber so as to aspirate fluid into the chamber; a locking mechanismmovable between a first state and a second state, wherein the lockingmechanism locks a position of the plunger seal relative to chamber whenthe locking mechanism is in the first state, and the locking mechanismpermits relative movement of the plunger seal relative to chamber whenthe locking mechanism is in the second state.
 23. A device as in claim22, wherein at least some of the finger elements are tabs.
 24. A deviceas in claim 22, wherein the locking mechanism is positioned such that auser can use a thumb to change the state of the locking mechanism whenthe pistol grip is in the hand of the user.
 25. A device as in claim 22,wherein the locking mechanism comprises a latch.
 26. A device as inclaim 22, further comprising: a connector structure having a first endwith an opening configured to receive a connector connector and a secondend with an opening configured to receive an end of the external syringebarrel; the connector structure having an internal contour sized andshaped to provide a smooth transition between the end of the externalsyringe barrel and the end of the connector such that the adapter formsan internal lumen connection between the chamber of the internal syringebarrel and the connector that lacks any ledges.
 27. A device as in claim26, further comprising a gasket inside the structure, the gasketconfigured to seal against the connector.